Alterations in Human Semen After Infection with SARS-CoV-2: A Meta-analysis

Alterations in Human Semen After Infection with SARS-CoV-2: A Meta-analysis

Affiliations

Free PMC article

Abstract

Background: The purpose of the current study was to assess pooled prevalence (PP) of SARS-CoV-2 in semen and pooled estimates including weighted mean difference (WMD) and risk ratio (RR) of semen characteristics in infected cases as compared with healthy controls.

Methods: Major databases were searched by two authors. SARS-CoV-2-positive cases were assigned to the exposed arm (group A), whereas the controls to the unex-posed (group B). Risk of bias was assessed with Newcastle-Ottawa Scale and PRISMA guidelines were followed. Random-effects model was employed for analyzing the heterogeneity and fixed-effects model for homogeneity of studies.

Results: Of 170 studies, 14 studies were eligible involving 507 subjects (316 in group A, 191 in group B). The risk of bias was the highest for „comparability” domain. SARS-CoV-2 RNA was found in only two studies among 7 subjects (PP= 2.10%, 95%CI 0.58-4.42). There was a significant decrease in sperm concentration (WMD= -15.29, 95%CI -24.70 – -5.88) and total sperm in ejaculate (WMD= -47.58, 95%CI -86.40 – -8.75) in group A. The effect of COVID-19 upon progressive motility, ejaculate volume, and leukocyte presence in semen was not significant.

Conclusion: Prevalence of SARS-CoV-2 in semen among the infected cases is low. Sexual transmission through semen is improbable and of little concern for public health. Sperm concentration and total sperm in ejaculate are significantly reduced as compared with controls. Due to limited information of the current research, longer follow-up is needed to identify delayed or progressive impact.

Keywords: COVID-19; Coronavirus; Meta-analysis; Pandemics; SARS-CoV-2; Semen.

Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Figure 1.

Figure 2.

References

    1. Cipriano M, Giacalone A, Ruberti E. Sexual behaviors during COVID-19: the potential risk of transmission. Arch Sex Behav. 2020;49(5):1431–2. – PMC PubMed
    1. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843–4. – PMC PubMed
    1. Karia R, Gupta I, Khandait H, Yadav A, Yadav A. COVID-19 and its Modes of Transmission. SN Compr Clin Med. 2020:1–4. Online ahead of print. – PMC PubMed
    1. Li W, Moore MJ, Vasllieva N, Sui J, Wong SK, Berne MA, et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003;426(6965):450–4. – PMC PubMed
    1. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HWG, Behre HM, et al. World health organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231–45. – PubMed
    1. Li D, Jin M, Bao P, Zhao W, Zhang S. Clinical characteristics and results of semen tests among men with Coronavirus disease 2019. JAMA Netw Open. 2020;3(5):e208292. – PMC PubMed
    1. Temiz MZ, Dincer MM, Hacibey I, Yazar RO, Celik C, Kucuk SH, et al. Investigation of SARS-CoV-2 in semen samples and the effects of COVID-19 on male sexual health by using semen analysis and serum male hormone profile: a cross-sectional, pilot study. Andrologia. 2021;53(2):e13912. – PMC PubMed
    1. Guo L, Zhao S, Li W, Wang Y, Li L, Jiang S, et al. Absence of SARS-CoV-2 in semen of a COVID-19 patient cohort. Andrology. 2021;9(1):42–7. – PMC PubMed
    1. Song C, Wang Y, Li W, Hu B, Chen G, Xia P, et al. Absence of 2019 novel coronavirus in semen and testes of COVID-19 patients. Biol Reprod. 2020;103 (1):4–6. – PMC PubMed
    1. Machado B, Barra GB, Scherzer N, Massey J, dos Santos Luz H, Jacomo RH, et al. Presence of SARS-CoV-2 RNA in semen-cohort study in the United States COVID-19 positive patients. Infect Dis Rep. 2021;13(1):96–101. – PMC PubMed
    1. Burke CA, Skytte A, Kasiri S, Howell D, Patel ZP, Trolice MP, et al. A cohort study of men infected with COVID-19 for presence of SARS-CoV-2 virus in their semen. J Assist Reprod Genet. 2021; 38(4):785–9. – PMC PubMed
    1. Li H, Xiao X, Zhang J, Zafar MI, Wu C, Long Y, et al. Impaired spermatogenesis in COVID-19 patients. EClinicalMedicine. 2020;28:100604. – PMC PubMed
    1. Rawlings SA, Ignacio C, Porrachia M, Du P, Smith DM, Chaillon A. No evidence of SARS-CoV-2 seminal shedding despite SARS-CoV-2 persistence in the upper respiratory tract. Open Forum Infect Dis. 2020;7(8):ofaa325. – PMC PubMed
    1. Pavone C, Giammanco GM, Baiamonte D, Pinelli M, Bonura C, Montalbano M, et al. Italian males recovering from mild COVID-19 show no evidence of SARS-CoV-2 in semen despite prolonged nasopharyngeal swab positivity. Int J Impot Res. 2020;32(5):560–2. – PMC PubMed
    1. Ruan Y, Hu B, Liu Z, Liu K, Jiang H, Li H, et al. No detection of SARS-CoV-2 from urine, expressed prostatic secretions, and semen in 74 recovered COVID-19 male patients: a perspective and urogenital evaluation. Andrology. 2021;9(1): 99–106. – PubMed
    1. Pan F, Xiao X, Guo J, Song Y, Li H, Patel DP, et al. No evidence of severe acute respiratory syndrome–coronavirus 2 in semen of males recovering from coronavirus disease 2019. Fertil Steril. 2020; 113(6):1135–9. – PMC PubMed
    1. Ma L, Xie W, Li D, Shi L, Ye G, Mao Y, et al. Evaluation of sex-related hormones and semen characteristics in reproductive-aged male COVID-19 patients. J Med Virol 2021;93(1):456–62. – PMC PubMed
    1. Kayaaslan B, Korukluoglu G, Hasanoglu I, Kalem AK, Eser F, Akinci E, et al. Investigation of SARS-CoV-2 in semen of patients in the acute stage of COVID-19 infection. Urol Int. 2020;104 (9–10):678–83. – PMC PubMed
    1. Holtmann N, Edimiris P, Andree M, Doehmen C, Baston-Buest D, Adams O, et al. Assessment of SARS-CoV-2 in human semen-a cohort study. Fertil Steril. 2020;114(2):233–38. – PMC PubMed
    1. Schrader C, Schielke A, Ellerbroek L, Johne R. PCR inhibitors-occurrence, properties and removal. J Appl Microbiol. 2012;113(5):1014–26. – PubMed
    1. Tobe SS, Swaran YC, Dennany L, Sibbing U, Schulze Johann K, Welch L, et al. A proof of principal study on the use of direct PCR of semen and spermatozoa and development of a differential isolation protocol for use in cases of alleged sexual assault. Int J Legal Med. 2017;131(1):87–94. – PubMed
    1. Carlsen E, Andersson AM, Petersen JH, Skakkebæk NE. History of febrile illness and variation in semen quality. Hum Reprod 2003;18(10):2089–92. – PubMed
WP Radio
WP Radio
OFFLINE LIVE